Summary of treatment

11:28 Open the airway to the patient, place an oropharyngeal vent tube in the oropharynx, and give oxygen to the high-flow mask. Establish 2 venous accesses for the patient, and then perform blood test.

11:38 The patient was given balloon-assisted ventilation; 20 mg etomidate and 100 mg succinylcholine chloride were given intravenously.

11:50 The patient was successfully placed in a 7.0# tracheal tube for sputum suction. The tracheal tube is connected to the ventilator for assisted breathing; the ventilator is set to SIMV mode, with a tidal volume of 400 ml, a respiratory rate of 14 times/min, and a positive end-breathing pressure of 4 cmH₂O.

11:54 The DR chest radiograph was performed at the bedside, and the image results are shown in Figure 2.

11:54 The patient developed ventilator resistance and was given an intravenous bolus of midazolam 2 mg and rocuronium 30 mg.

11:58 After closed drainage of the thoracic cavity on both sides, a large number of bubbles were induced.

12:19 The patient’s SpO₂ fluctuates in the range of 33% - 76%. After bronchoscopy, it was found that his right main bronchus was damaged.

12:36 Because the patient’s heart rate dropped to 41 beats/min, the blood pressure was undetectable, and the carotid artery pulsation was weak, so chest compressions were given.

12:37 The patient’s heart rate rises to 66 beats per minute, and the carotid pulse can be palpable.

12:40 After intravenous bolus of 20 mg rocuronium was given, bronchoscopy was performed again. After the tracheal tube is removed, the double-lumen tracheal tube is inserted through the auxiliary replacement of the bronchoscope. The left main bronchus was inserted into the front end of the catheter, and the insertion depth was 29 cm. The upper end of the catheter is inflated to seal the right main bronchus. Adjust the ventilator parameters as: SIMV, VT400 ml, RR18 times/min. One-lung ventilation was given to the left lung.

12:43 Because the patient’s heart rate dropped to 43 beats/min, the blood pressure was undetectable, and the carotid artery pulsation was weak, so chest compressions were given.

12:45 The patient’s heart rate rose to 102 beats per minute.

12:55 The patient’s blood oxygen saturation rose to 100%, and his condition stabilized. After the patient went to the CT room for examination, he returned to the rescue room.

13:05 Chest CT examination and chest 3D reconstruction, the image result is shown in Figure 3.

13:13 Heart rate rises, blood pressure rises. He was given 20 mg IV of rocuronium bromide and 2 mg IV of midazolam.

13:30 The green channel leads directly to the operating room.